Easing Chronic Pain: Better Treatments and Medications

What Is Pain?

You know it at once. It may be the fiery sensation of a burn moments after your finger touches the stove. Or it's a dull ache above your brow after a day of stress and tension. Or you may recognize it as a sharp pierce in your back after you lift something heavy. In its most benign form, pain warns us that something isn't quite right, that we should take medicine, or see a doctor. At its worst, however, pain robs us of our productivity, our well being, and, ultimately, our very lives.

In 1931, the French medical missionary Dr. Albert Schweitzer wrote, "Pain is a more terrible lord of mankind than even death itself." Today, pain has become the universal disorder, a serious and costly public health issue, and a challenge for family, friends, and health care providers who must give support to the individual suffering from the physical as well as the emotional consequences of pain.

Pain is a feeling triggered in the nervous system. Pain may be sharp or dull. It may come and go, or it may be constant. You may feel pain in one area of your body, such as your back, abdomen, or chest, or you may feel pain all over, such as when your muscles ache from the flu.

Pain can be helpful. Without pain, you might seriously hurt yourself without knowing it, or you might not realize you have a medical problem that needs treatment. Once you take care of the problem, pain usually goes away. However, sometimes pain goes on for weeks, months, or even years. Fortunately, there are many ways to treat pain. Treatment varies depending on the cause of pain.

It is useful to distinguish between two basic types of pain, acute and chronic, and they differ greatly.

Acute pain, for the most part, results from disease, inflammation, or injury to tissues. This type of pain generally comes on suddenly. For example, pain may occur after trauma or surgery, and may be accompanied by anxiety or emotional distress. The cause of acute pain can usually be diagnosed and treated, and the pain is confined to a given period of time and severity. In some rare instances, it can become chronic.

Chronic pain is widely believed to represent disease itself. It can be made much worse by environmental and psychological factors. Chronic pain persists over a longer period of time than acute pain and is resistant to most medical treatments. It can—and often does—cause severe problems for patients.

How is Pain Treated?

Whatever the treatment method, it is important to remember that pain is treatable. Here are some common pain treatments.

Treatment

Used for

Drugs

Examples are aspirin, acetaminophen, and NSAIDs (non-steroidal anti-inflammatory drugs, such as ibuprofen.) These pain relievers, also called analgesics, treat anything from minor aches to arthritis. Other drugs that are sometimes used for pain include anticonvulsants, antidepressants, antimigraine drugs, COX-2 inhibitors, and narcotics.

Chemical injections or applications

Examples include capsaicin, a chemical found in chili peppers used in pain-relieving creams; nerve blocks with drugs or chemicals to interrupt relay of pain messages between the brain and other parts of the body; and enzymes injected into lumbar disks.

Physical methods

Common treatments include physical therapy, biofeedback, acupuncture, electrical stimulation, R.I.C.E. (Rest, Ice, Compression, and Elevation, for muscle and bone conditions), and exercise to improve blood flow and oxygen to muscles and relieve stress.

Psychological methods

These include counseling, hypnosis, and cognitive-behavioral therapy—a treatment that involves a wide variety of coping skills and relaxation methods to help prepare for and cope with pain.

Surgery

Although not always an option, surgery may be required to relieve pain, especially pain caused by back problems or serious musculoskeletal injuries.